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McCarthy was born in Dublin.[1] He joined Leicester City in March 2005 for a fee of £100,000 from Manchester City, signing a three-year contract.[3] He had never played for Manchester City's first team but had enjoyed loan spells at Boston United and Notts County during 2002 and 2003. Boston had made a bid to sign McCarthy on a permanent basis in February 2003.[4]

McCarthy became a favourite with the Leicester fans, due to his no-nonsense style of play, and in July 2006 was named club captain for the 2006–07 season. His season was cut short when he dislocated his shoulder in a training accident in February 2007.[5] Nonetheless, McCarthy expressed his wish to leave Leicester before the start of next season, despite being offered a new contract.[6]

McCarthy moved to Charlton Athletic for a fee of £650,000 in June 2007,[7] but spent only a year at The Valley, moving across south-east London to sign for Crystal Palace in the summer of 2008, with Mark Hudson travelling in the opposite direction.[7] McCarthy was troubled by a series of shoulder injuries which restricted him from playing in much of the 2008–09 and the 2009–10 seasons, but this did not stop him being named Palace captain in the run-up to the 2010–11 season.

McCarthy missed the entire 2012–13 season with a groin injury, and made only one appearance in the subsequent Premier League season.[8] Despite this, he signed a one-year contract extension with Palace in September 2014.[9] Despite being given a new deal, first-team chances remained limited, and so, on 3 October 2014, McCarthy joined Sheffield United on an initial one-month loan deal[10] and made his début the following day as United lost 3–2 away at Chesterfield.[11] His first goal for the Blades came in the next match in a 2–2 draw against Leyton Orient at Bramall Lane.[12] At the end of the loan period McCarthy returned to Palace and was named amongst the substitutes for an away fixture against Manchester United on 8 November.[13] However, on 11 November, it was confirmed that McCarthy's loan with the Blades had been renewed until 28 December 2014.[14][15] In his first game back at United, McCarthy was sent off in a Yorkshire derby away at Doncaster Rovers with ten men United eventually going on to win 1–0.[16]

McCarthy signed for Bolton Wanderers on loan in March 2015, a prankster had telephoned the West Bromwich Albion manager Tony Pulis pretending to be Bolton manager Neil Lennon weeks previously, with an enquiry for Gareth McAuley as the main point of interest. Pulis himself recommended his old Palace captain McCarthy, whom Bolton duly signed in an unconnected incident later in the season. McCarthy made five appearances in a Bolton shirt, but had to return to Palace after picking up an injury in Wanderers 2-2 draw with Brentford at Griffin Park.

McCarthy signed for newly promoted Preston North End on 3 October on a 93-day loan, and went straight into the squad to make his debut against Sheffield Wednesday on the same day.[17] However, he was substituted after 10 minutes due to injury.[18]

On 13 June 2016, it was announced that McCarthy would be released by Crystal Palace on expiry of his contract on 30 June.[19]